Recent advances in cell culture and tissue engineering permit the successful treatment of deep articular defects with autologous chondrocyte transplantation. While chondrocyte culturing from articular cartilage is commonplace, in vitro growth of chondrocytes from temporomandibular joint fibrocartilage has not been defined. Likewise, the concept of autologous chondrocyte transplantation has not been applied to the temporomandibular joint. Since fibrocartilage differs structurally and functionally from articular cartilage, an effective culturing method for this tissue is essential as well. The ultimate goal of this project is to enable the use of autologous temporomandibular joint chondrocyte transplantation for the regeneration of damaged or missing components of the joint. The aim of this pilot study is to develop an effective cell culturing technique for chondrocytes harvested from the temporomandibular joint disc of dogs. Cartilage of the temporomandibular joint disc of drug-free mongrel dogs was dissected, dissociated, and centrifuged for chondrocyte collection. Blood specimen was collected from the same animal to produce the autologous serum. Chondrocytes were then dispersed in 24-well plates and incubated in one of four media, DMEM (Dulbecco's modified Eagle's medium), Ham's F-12, DMEM/F-12, or Iscove's MDM(modified Dulbecco's medium). Each medium was also mixed with either 10% fetal bovine serum or 10% autologous serum. Temporomandibular joint disc chondrocytic proliferation was tested in all the culture media with sera on the fifth day. The initial plating count was held constant throughout at 1 x 10(4) cells/well and eight samples were evaluated in each culture. The results demonstrated that fetal bovine serum worked much better than autologous serum in all evaluated media and that DMEM/F-12 mixed with 10% fetal bovine serum was the most optimal culture condition for expansion of temporomandibular joint disc chondrocytes.
Animals ; Cartilage ; Cartilage, Articular ; Cell Culture Techniques ; Chondrocytes ; Culture Media ; Dogs ; Fibrocartilage ; Joints ; Pilot Projects ; Regeneration ; Temporomandibular Joint Disc* ; Temporomandibular Joint* ; Tissue Engineering

PURPOSE: Anti-rheumatic agents target common molecular pathways of inflammation in rheumatoid arthritis (RA) and periodontitis. The purpose of this study was to determine the relative effect of anti-rheumatic agents on the levels of inflammatory biomarkers and periodontal inflammation in RA patients with periodontitis. METHODS: A systematic review and meta-analysis were conducted of studies comparing periodontal parameters of inflammation, such as bleeding on probing, and biomarkers of inflammation in RA patients with periodontitis and healthy adults with and without periodontitis. The search included the electronic databases MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar, inclusive through October 2011, with no language restrictions. Hand searches were conducted of the bibliographies of related journals and systematic reviews. Observational and interventional studies assessing the effects of antirheumatic therapy qualified for inclusion. Two reviewers performed independent data extraction and risk-of-bias assessment. Of the 187 identified publications, 13 studies fulfilled the inclusion criteria. RESULTS: When compared to healthy adults without periodontitis, RA subjects were found to have significantly higher levels of bleeding on probing and limited evidence of higher levels of interleukin-1beta and tumor necrosis factor-alpha (TNF-alpha) in gingival crevicular fluid and saliva. No consistent differences were found in periodontal parameters and inflammatory biomarkers between RA subjects and adults with periodontitis. Studies evaluating the effect of anti-TNF-alpha therapy in RA subjects with periodontitis have yielded inconsistent results. CONCLUSIONS: There are limited data, however, to suggest that anti-TNF-alpha agents can reduce local production of inflammatory cytokines and periodontal inflammation in RA patients with periodontitis.
Adult ; Antirheumatic Agents ; Arthritis, Rheumatoid ; Biomarkers ; Cytokines ; Electronics ; Electrons ; Gingival Crevicular Fluid ; Hand ; Hemorrhage ; Humans ; Inflammation ; Interleukin-1beta ; Periodontitis ; Saliva ; Tumor Necrosis Factor-alpha

PURPOSE: To examine geographical imbalances by analyzing new graduate nurses' migration patterns among regions where they grew up, attended nursing school, and had their first employment and to identify factors related to working in non-metropolitan areas. METHODS: The sample consisted of 507 new graduates working in hospitals as full-time registered nurses in South Korea. Migration patterns were categorized into 5 patterns based on sequential transitions of "geographic origin-nursing school-hospital." Multiple logistic regression analysis was conducted to identify factors associated with working in non-metropolitan hospitals. RESULTS: Nurses who grew up, graduated, and worked in the same region accounted for the greatest proportion (54%). Sixty-five percent had their first employment in the region where they graduated. Nurses tended to move from poor to rich regions and from non-metropolitan to metropolitan areas. Working in non-metropolitan hospitals was related to older age, the father having completed less than 4 years of college education, non-metropolitan origin, non-capital city school graduation, and a diploma (vs. baccalaureate) degree. CONCLUSION: Admitting students with rural backgrounds, increasing rural nursing school admission capacities, and providing service-requiring scholarships, particularly for students from low-income families, are recommended to address geographical imbalances.
Adult ; Attitude of Health Personnel ; Education, Nursing, Baccalaureate ; Employment ; Female ; Hospitals, Rural ; Hospitals, Urban ; Humans ; Logistic Models ; Male ; Nursing Staff, Hospital/*psychology ; Poverty ; Professional Practice Location

Regulation of cell volume is an important aspect of cellular homeostasis during neural activity. This volume regulation is thought to be mediated by activation of specific transporters, aquaporin, and volume regulated anion channels (VRAC). In cultured astrocytes, it was reported that swelling-induced mitogen-activated protein (MAP) kinase activation is required to open VRAC, which are thought to be important in regulatory volume decrease and in the response of CNS to trauma and excitotoxicity. It has been also described that sodium fluoride (NaF), a recognized G-protein activator and protein phosphatase inhibitor, leads to a significant MAP kinase activation in endothelial cells. However, NaF's effect in volume regulation in the brain is not known yet. Here, we investigated the mechanism of NaF-induced volume change in rat and mouse hippocampal slices using intrinsic optical signal (IOS) recording, in which we measured relative changes in intracellular and extracellular volume as changes in light transmittance through brain slices. We found that NaF (1~5 mM) application induced a reduction in light transmittance (decreased volume) in CA1 hippocampus, which was completely reversed by MAP kinase inhibitor U0126 (10 µM). We also observed that NaF-induced volume reduction was blocked by anion channel blockers, suggesting that NaF-induced volume reduction could be mediated by VRAC. Overall, our results propose a novel molecular mechanism of NaF-induced volume reduction via MAP kinase signaling pathway by activation of VRAC.
Animals ; Astrocytes ; Brain ; Cell Size ; Endothelial Cells ; Fluorides* ; GTP-Binding Proteins ; Hippocampus ; Homeostasis ; Mice ; Phosphotransferases* ; Rats ; Sodium Fluoride

Regulation of cell volume is an important aspect of cellular homeostasis during neural activity. This volume regulation is thought to be mediated by activation of specific transporters, aquaporin, and volume regulated anion channels (VRAC). In cultured astrocytes, it was reported that swelling-induced mitogen-activated protein (MAP) kinase activation is required to open VRAC, which are thought to be important in regulatory volume decrease and in the response of CNS to trauma and excitotoxicity. It has been also described that sodium fluoride (NaF), a recognized G-protein activator and protein phosphatase inhibitor, leads to a significant MAP kinase activation in endothelial cells. However, NaF's effect in volume regulation in the brain is not known yet. Here, we investigated the mechanism of NaF-induced volume change in rat and mouse hippocampal slices using intrinsic optical signal (IOS) recording, in which we measured relative changes in intracellular and extracellular volume as changes in light transmittance through brain slices. We found that NaF (1~5 mM) application induced a reduction in light transmittance (decreased volume) in CA1 hippocampus, which was completely reversed by MAP kinase inhibitor U0126 (10 µM). We also observed that NaF-induced volume reduction was blocked by anion channel blockers, suggesting that NaF-induced volume reduction could be mediated by VRAC. Overall, our results propose a novel molecular mechanism of NaF-induced volume reduction via MAP kinase signaling pathway by activation of VRAC.
Animals ; Astrocytes ; Brain ; Cell Size ; Endothelial Cells ; Fluorides* ; GTP-Binding Proteins ; Hippocampus ; Homeostasis ; Mice ; Phosphotransferases* ; Rats ; Sodium Fluoride

Red cell antigens, A, B, and H can be weakened or lost especially in patients with hematologic malignancies. We report a 42-year-old female patient with acute myeloid leukemia, who showed loss of A antigen on her red cells. She showed the persistence of leukemia in spite of three cycles of induction chemotherapy. Her ABO blood group showed a discrepancy: the cell type was O and the serum type was A. Adsorption/elution test could not identify the presence of A antigen on her red cells, and the test for A and B transferases was negative. ABO genotyping using PCR/restriction fragment length polymorphism and sequencing of exons 6 and 7 of the ABO gene demonstrated 467 C>T substitution in exon 7 and confirmed the genotype of A102/O01. She was transfused with leukapheresis products collected from donors with blood group A, but expired of severe sepsis. This is the first Korean case, in which red cell A antigen loss was genetically proven using sequencing, and underscores the necessity of ABO genotyping to solve the ABO discrepancy and to transfuse effectively.
Adult ; Exons ; Female ; Genotype ; Hematologic Neoplasms ; Humans ; Induction Chemotherapy ; Leukapheresis ; Leukemia ; Leukemia, Myeloid, Acute ; Sepsis ; Tissue Donors ; Transferases

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is closely associated with diabetes. The cumulative impact of both diseases synergistically increases risk of adverse events. However, present population analysis is predominantly conducted with reference to non-NAFLD individuals and has not yet examined the impact of prediabetes. Hence, we sought to conduct a retrospective analysis on the impact of diabetic status in NAFLD patients, referencing non-diabetic NAFLD individuals. Methods: Data from the National Health and Nutrition Examination Survey 1999–2018 was used. Hepatic steatosis was defined with United States Fatty Liver Index (US-FLI) and FLI at a cut-off of 30 and 60 respectively, in absence of substantial alcohol use. A multivariate generalized linear model was used for risk ratios of binary outcomes while survival analysis was conducted with Cox regression and Fine Gray model for competing risk. Results: Of 32,234 patients, 28.92% were identified to have NAFLD. 36.04%, 38.32% and 25.63% were non-diabetic, prediabetic and diabetic respectively. Diabetic NAFLD significantly increased risk of cardiovascular disease (CVD), stroke, chronic kidney disease, all-cause and CVD mortality compared to non-diabetic NAFLD. However, prediabetic NAFLD only significantly increased the risk of CVD and did not result in a higher risk of mortality. Conclusions Given the increased risk of adverse outcomes, this study highlights the importance of regular diabetes screening in NAFLD and adoption of prompt lifestyle modifications to reduce disease progression. Facing high cardiovascular burden, prediabetic and diabetic NAFLD individuals can benefit from early cardiovascular referrals to reduce risk of CVD events and mortality.

We analyzed the efficacy and toxicity of a modified Cancer and Leukemia Group B (CALGB) 19802 regimen in adult acute lymphoblastic leukemia (ALL). From February 2002 to August 2005, 25 adults with untreated ALL were enrolled in the study. Compared to the original regimen, the modified CALGB 19802 regimen consisted of a 4-drug induction (cyclophosphamide, daunorubicin, vincristine, and prednisone) instead of a 5-drug induction (L-asparaginase was added to the previous regimen). This was followed by high-dose methotrexate (1,000 mg/m(2)X3 days) and cytarabine (2,000 mg/m(2)X4 days) for the consolidation cycles. High-dose systemic and intrathecal methotrexate was given for central nervous system prophylaxis. Twentythree patients (92%) achieved a complete remission (CR), and two patients (8%) had refractory disease. With a median follow-up of 21.5 months, 10 patients (40%) were alive and continued to be in CR. The 3-yr probability of an event-free survival and the overall survival were 39.0% and 47.4%, respectively. Treatment related mortality and major grade 3 to 4 neurotoxicity occurred in 1 patient and 3 patients, respectively. The modified CALGB 19802 regimen demonstrated a high remission rate and a favorable survival rate.
Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Cyclophosphamide/*administration & dosage ; Daunorubicin/*administration & dosage ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy ; Prednisone/*administration & dosage ; Remission Induction ; Treatment Outcome ; Vincristine/*administration & dosage

Although lead intoxication is commonly mentioned as a cause of sideroblastic anemia, no well-documented case exists in the literature. We encountered a patient with sideroblastic anemia caused by lead-containing herbal medicine. A 34-year-old woman was admitted to our hospital with abdominal pain. She had taken herbal medicine for her general health. Anemia, hyperbilirubinemia, and elevated lactic dehydrogenase were found from the laboratory data. Bone marrow biopsy showed pathological ringed sideroblasts. Her serum level of lead was high and the lead content of the tablet was higher than permitted. We diagnosed her with sideroblastic anemia secondary to lead poisoning caused by herbal medicine. We stopped her from taking herbal medicine and she gradually recovered from anemia.
Abdominal Pain ; Adult ; Anemia ; Anemia, Sideroblastic ; Biopsy ; Bone Marrow ; Female ; Herbal Medicine ; Humans ; Hyperbilirubinemia ; Lead Poisoning ; Oxidoreductases